title: Large symptomatic gastric diverticula: two case reports and a brief review of literature.
abstract: Gastric diverticula are rare and uncommon conditions. Most gastric diverticula are asymptomatic. When symptoms arise, they are most commonly upper abdominal pain, nausea and emesis, while dyspepsia and vomiting are less common. Occasionally, patients with gastric diverticula can have dramatic presentations related to massive bleeding or perforation. The diagnosis may be difficult, as symptoms can be caused by more common gastrointestinal pathologies and only aggravated by diverticula. The appropriate management of diverticula depends mainly on the symptom pattern and as well as diverticulum size. There is no specific therapeutic strategy for an asymptomatic diverticulum. Although some authors support conservative therapy with antacids, this provides only temporary symptom relief since it is not able to resolve the underlying pathology. Surgical resection is the mainstay of treatment when the diverticulum is large, symptomatic or complicated by bleeding, perforation or malignancy, with over two-thirds of patients remaining symptom-free after surgery, while laparoscopic resection, combined with intraoperative endoscopy, is a safe and feasible approach with excellent outcomes. Here, we present two cases of uncommon large symptomatic gastric diverticula with a discussion of the cornerstones in management and report a minimally invasive solution, with a brief review of the literature.
authors.affiliation: Luigi Marano, Gianmarco Reda, Raffaele Porfidia, Michele Grassia, Marianna Petrillo, Giuseppe Esposito, Francesco Torelli, Angelo Cosenza, Giuseppe Izzo, Natale Di Martino, 8 General and Gastrointestinal Surgery, Department of Internal Medicine, Surgical, Neurological Metabolic Disease and Geriatric Medicine, Second University of Naples, 80138 Naples, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Marano
authors.forename: Gianmarco
authors.initials: G
authors.lastname: Reda
authors.forename: Raffaele
authors.initials: R
authors.lastname: Porfidia
authors.forename: Michele
authors.initials: M
authors.lastname: Grassia
authors.forename: Marianna
authors.initials: M
authors.lastname: Petrillo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Esposito
authors.forename: Francesco
authors.initials: F
authors.lastname: Torelli
authors.forename: Angelo
authors.initials: A
authors.lastname: Cosenza
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Izzo
authors.forename: Natale
authors.initials: N
authors.lastname: Di Martino
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D013273:Diverticulum, Stomach / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D017792:Surgical Stapling; D016896:Treatment Outcome
keywords: Abdominal pain; Diverticulum; Dysphagia; Gastric; Gastric diverticulum; Laparoscopic gastric diverticulectomy